SEC Form 4 · accession 0001144204-19-003515
DarioHealth Corp. · DRIO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Erez Raphael
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Jan 27, 2019
Accepted (ET)
Jan 29, 2019 · 4:03 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001533998
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jan 27, 2019 | P$0 | 61,969 | $0.00 | A | 1,397,436 | D | |
| Common StockF2 | holding | — | — | — | 757,509 | I | By Dicilyon Consulting and Investment Ltd. |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reporting person was awarded such securities in exchange for waiving director fees owed for the first quarter of 2019 in the amount of $61,969.43.
- F2The amount shown represents the beneficial ownership of the issuer's securities held by Dicilyon Consulting and Investment Ltd. which may be deemed to be attributable to Mr. Raphael because Mr. Raphael possesses voting and dispositive power over the securities held by Dicilyon Consulting and Investment Ltd. by virtue of a proxy. Mr. Raphael disclaims beneficial ownership of the securities set forth herein.